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Transcript
Osteomyelitis Inflammation with an Infectious cause. Osteomyelitis affects the bones; septic arthritis affects the joints. Etiology Osteomyelitis Hematogenous Secondary to adjacent infection Direct inoculation Vascular Primary agents causing insufficiency osteomyelitis: staph, strep, gonorrhea Septic Arthritis Etiology – Hematogenous – Direct inoculation Agents – staph, strep, gonorrhea, viral, post rubella Development of Osteomyelitis Classification of osteomyelitis Acute Chronic Sinus tracts form, bone destruction Development of Osteomyelitis Bacteria invade bone Pressure within bone increases Periosteum elevates and bone DIES Infected bone separates = sequestrum Separated periosteum produces new bone = involcrum Sinus tract forms Osteomyelitis Signs and symptoms – Acute 24-48 hrs post-surgery – Pain – Swelling, erythemia – Pseudoarthrosis – Chronic Diagnostic tests – X-ray, no initial bone changes – CT, MRI. biopsy – Culture – Late bone changes with bone destruction Septic Arthritis Signs and symptoms – Painful – Loss of motion – High fever – Less likely to become chronic Diagnostic tests – Lab studies – X-rays show synovial effusion – Arthrocenthesis with culture Synovial inflammation! Comparison acute rheumatoid arthritis and septic arthritis of the joint! Purulent exudate! Management Interventions – Acute: prevent, identify source, short-term Nursing antibiotics Diagnosis – Chronic: opt – Alteration in nutrition, splint for comfort support, – Potential for injury: surgery,hyperbaric fracture O2, muscle flap, – Hyperthemia long term – Knowledge deficit antibiotics If only I had taken those antibiotics! Avoid the pain and grief of chronic osteomyelitis! Tuberculosis of Bone and Spine Source Signs and symptoms: vertebral collapse, pain, deformity (Potts fx), systemic as night sweats, anemia Diagnosis Treatment Test Yourself! Sixty days following her TKR, Ms. K calls her physician to report “a little pain and swelling “ around her knee. What advice would you give her? – a. “That is expected.” – b. “Wait and see what happens.” – c. “Let me check the knee.” – d. “You may need an antibiotic.”
